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Ezaki R, Sakuma T, Kodama D, Sasahara R, Shiraogawa T, Ichikawa K, Matsuzaki M, Handa A, Yamamoto T, Horiuchi H. Transcription activator-like effector nuclease-mediated deletion safely eliminates the major egg allergen ovomucoid in chickens. Food Chem Toxicol 2023; 175:113703. [PMID: 36889429 DOI: 10.1016/j.fct.2023.113703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 02/15/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023]
Abstract
Among the major egg allergens, ovomucoid (OVM) is very stable against heat and digestive enzymes, making it difficult to remove physiochemically and inactivate allergens. However, recent genome editing technology has made it possible to generate OVM-knockout chicken eggs. To use this OVM-knockout chicken egg as food, it is important to evaluate its safety as food. Therefore, in this study, we examined the presence or absence of mutant protein expression, vector sequence insertion, and off-target effects in chickens knocked out with OVM by platinum TALENs. The eggs laid by homozygous OVM-knockout hens showed no evident abnormalities, and immunoblotting showed that the albumen contained neither the mature OVM nor the OVM truncated variant. Whole genome sequencing (WGS) revealed that the potential TALEN-induced off-target effects in OVM-knockout chickens were localized in the intergenic and intron regions. The WGS information confirmed that plasmid vectors used for genome editing were only transiently present and did not integrate into the genome of edited chickens. These results indicate the importance of safety evaluation and reveal that the eggs laid by this OVM knockout chicken solve the allergy problem in food and vaccines.
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Affiliation(s)
- Ryo Ezaki
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan.
| | - Tetsushi Sakuma
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan; Genome Editing Innovation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Daisuke Kodama
- R&D Division, Institute of Technology Solution, Kewpie Corporation, Sengawa Kewport, Chofu, Tokyo, Japan
| | - Ryou Sasahara
- R&D Division, Institute of Technology Solution, Kewpie Corporation, Sengawa Kewport, Chofu, Tokyo, Japan
| | - Taichi Shiraogawa
- R&D Division, Institute of Technology Solution, Kewpie Corporation, Sengawa Kewport, Chofu, Tokyo, Japan
| | - Kennosuke Ichikawa
- Genome Editing Innovation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Mei Matsuzaki
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Akihiro Handa
- Division of Life Science, School of Science and Engineering, Tokyo Denki University, Saitama, Japan
| | - Takashi Yamamoto
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan; Genome Editing Innovation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
| | - Hiroyuki Horiuchi
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan; Genome Editing Innovation Center, Hiroshima University, Higashi-Hiroshima, Hiroshima, Japan
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Huang CH, Liu YC, Shen JY, Lu FI, Shaw SY, Huang HJ, Chang CC. Repairing TALEN-mediated double-strand break by microhomology-mediated recombination in tobacco plastids generates abundant subgenomic DNA. Plant Sci 2021; 313:111028. [PMID: 34763881 DOI: 10.1016/j.plantsci.2021.111028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/18/2021] [Accepted: 08/19/2021] [Indexed: 06/13/2023]
Abstract
Transcription activator-like effector nuclease (TALEN) technology has been widely used to edit nuclear genomes in plants but rarely for editing organellar genomes. In addition, ciprofloxacin, commonly used to cause the double-strand break of organellar DNA for studying the repair mechanism in plants, confers no organellar selectivity and site-specificity. To demonstrate the feasibility of TALEN-mediated chloroplast DNA editing and to use it for studying the repair mechanism in plastids, we developed a TALEN-mediated editing technology fused with chloroplast transit peptide (cpTALEN) to site-specifically edit the rpoB gene via Agrobacteria-mediated transformation of tobacco leaf. Transgenic plants showed various degrees of chlorotic phenotype. Repairing damaged plastid DNA resulted in point mutation, large deletion and small inversion surrounding the rpoB gene by homologous recombination and/or microhomology-mediated recombination. In an albino line, microhomology-mediated recombination via a pair of 12-bp direct repeats between rpoC2 and ycf2 genes generated the chimeric ycf2-rpoC2 subgenome, with the level about 3- to 5-fold higher for subgenomic DNA than ycf2. Additionally, the expression of chimeric ycf2-rpoC2 transcripts versus ycf2 mRNA agreed well with the level of corresponding DNA. The ycf2-rpoC2 subgenomic DNA might independently and preferentially replicate in plastids.
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Affiliation(s)
- Chih-Hao Huang
- Institute of Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan
| | - Yu-Chang Liu
- Institute of Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan
| | - Jia-Yi Shen
- Institute of Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan
| | - Fu-I Lu
- Institute of Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan
| | - Shyh-Yu Shaw
- Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan; Department of Chemistry, National Cheng Kung University, Tainan, 701, Taiwan
| | - Hao-Jen Huang
- Department of Life Sciences, National Cheng Kung University, Tainan, 701, Taiwan; Institute of Tropical Plant Sciences and Microbiology, National Cheng Kung University, Tainan, 701, Taiwan
| | - Ching-Chun Chang
- Institute of Biotechnology, National Cheng Kung University, Tainan, 701, Taiwan; Department of Biotechnology and Bioindustry Sciences, National Cheng Kung University, Tainan, 701, Taiwan; Institute of Tropical Plant Sciences and Microbiology, National Cheng Kung University, Tainan, 701, Taiwan.
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Shiota Y, Sakurai T. Silencing of OBP genes: Generation of loss-of-function mutants of PBP by genome editing. Methods Enzymol 2020; 642:325-44. [PMID: 32828259 DOI: 10.1016/bs.mie.2020.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Pheromone binding proteins (PBPs) are small soluble proteins (about 15kDa) that play striking roles in the detection of sex pheromones in insects. Many studies including structural analysis, binding simulation, and in vitro assays have been performed to clarify the modes of action of PBPs. Although these studies have provided valuable contributions toward the understanding of which key amino acid components contribute to the correct folding of PBPs and their binding affinities to sex pheromones, the functional characteristics of PBPs in the natural environment is still obscure. Recent developments in genome editing have begun to enable the functional examination of PBPs in in vivo. Among insect PBPs, BmPBP1 is one of the most well-characterized, there being rich understanding of its structure, biochemical analysis, binding affinity, localization, and the relationship between the type of olfactory receptors and its expression. A recent study has shown that BmPBP1 contributes sensitivity, but not selectivity of sex pheromone detection in the silkmoth Bombyx mori. In this chapter, based on a current report of the functional characterization of BmPBP1 using genome editing, we provide one example of a useful analytical method to clarify the functional role of PBP in vivo.
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Abstract
Animal models of tumor initiation and tumor progression are essential components toward understanding cancer and designing/validating future therapies. Zebrafish is a powerful model for studying tumorigenesis and has been successfully exploited in drug discovery. According to the zebrafish reference genome, 82 % of disease-associated genes in the Online Mendelian Inheritance in Man (OMIM) database have clear zebrafish orthologues. Using a variety of large-scale random mutagenesis methods developed to date, zebrafish can provide a unique opportunity to identify gene mutations that may be associated with cancer predisposition. On the other hand, newer technologies enabling targeted mutagenesis can facilitate reverse cancer genetic studies and open the door for complex genetic analysis of tumorigenesis. In this chapter, we will describe the various technologies for conducting genome editing in zebrafish with special emphasis on the approaches to inactivate genes.
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Affiliation(s)
- John M Parant
- Department of Pharmacology and Toxicology, UAB Comprehensive Cancer Center, University of Alabama at Birmingham School of Medicine, Birmingham, AL, 35294, USA.
| | - Jing-Ruey Joanna Yeh
- Cardiovascular Research Center, Massachusetts General Hospital, Charlestown, MA, 02129, USA. .,Department of Medicine, Harvard Medical School, Boston, MA, 02115, USA.
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Hatada S, Subramanian A, Mandefro B, Ren S, Kim HW, Tang J, Funari V, Baloh RH, Sareen D, Arumugaswami V, Svendsen CN. Low-Dose Irradiation Enhances Gene Targeting in Human Pluripotent Stem Cells. Stem Cells Transl Med 2015; 4:998-1010. [PMID: 26185257 DOI: 10.5966/sctm.2015-0050] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/27/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED Human pluripotent stem cells (hPSCs) are now being used for both disease modeling and cell therapy; however, efficient homologous recombination (HR) is often crucial to develop isogenic control or reporter lines. We showed that limited low-dose irradiation (LDI) using either γ-ray or x-ray exposure (0.4 Gy) significantly enhanced HR frequency, possibly through induction of DNA repair/recombination machinery including ataxia-telangiectasia mutated, histone H2A.X and RAD51 proteins. LDI could also increase HR efficiency by more than 30-fold when combined with the targeting tools zinc finger nucleases, transcription activator-like effector nucleases, and clustered regularly interspaced short palindromic repeats. Whole-exome sequencing confirmed that the LDI administered to hPSCs did not induce gross genomic alterations or affect cellular viability. Irradiated and targeted lines were karyotypically normal and made all differentiated lineages that continued to express green fluorescent protein targeted at the AAVS1 locus. This simple method allows higher throughput of new, targeted hPSC lines that are crucial to expand the use of disease modeling and to develop novel avenues of cell therapy. SIGNIFICANCE The simple and relevant technique described in this report uses a low level of radiation to increase desired gene modifications in human pluripotent stem cells by an order of magnitude. This higher efficiency permits greater throughput with reduced time and cost. The low level of radiation also greatly increased the recombination frequency when combined with developed engineered nucleases. Critically, the radiation did not lead to increases in DNA mutations or to reductions in overall cellular viability. This novel technique enables not only the rapid production of disease models using human stem cells but also the possibility of treating genetically based diseases by correcting patient-derived cells.
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Affiliation(s)
- Seigo Hatada
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Aparna Subramanian
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Berhan Mandefro
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Songyang Ren
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Ho Won Kim
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jie Tang
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vincent Funari
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Robert H Baloh
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Dhruv Sareen
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Vaithilingaraja Arumugaswami
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Clive N Svendsen
- Board of Governors, Regenerative Medicine Institute, Department of Biomedical Sciences, iPSC Core, The David and Janet Polak Foundation Stem Cell Core Laboratory, Genomics Core Facility, Department of Surgery, and Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
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Jia J, Bai F, Jin Y, Santostefano KE, Ha UH, Wu D, Wu W, Terada N, Jin S. Efficient Gene Editing in Pluripotent Stem Cells by Bacterial Injection of Transcription Activator-Like Effector Nuclease Proteins. Stem Cells Transl Med 2015; 4:913-26. [PMID: 26062981 DOI: 10.5966/sctm.2015-0030] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 04/27/2015] [Indexed: 11/16/2022] Open
Abstract
The type III secretion system (T3SS) of Pseudomonas aeruginosa is a powerful tool for direct protein delivery into mammalian cells and has successfully been used to deliver various exogenous proteins into mammalian cells. In the present study, transcription activator-like effector nuclease (TALEN) proteins have been efficiently delivered using the P. aeruginosa T3SS into mouse embryonic stem cells (mESCs), human ESCs (hESCs), and human induced pluripotent stem cells (hiPSCs) for genome editing. This bacterial delivery system offers an alternative method of TALEN delivery that is highly efficient in cleavage of the chromosomal target and presumably safer by avoiding plasmid DNA introduction. We combined the method of bacterial T3SS-mediated TALEN protein injection and transfection of an oligonucleotide template to effectively generate precise genetic modifications in the stem cells. Initially, we efficiently edited a single-base in the gfp gene of a mESC line to silence green fluorescent protein (GFP) production. The resulting GFP-negative mESC was cloned from a single cell and subsequently mutated back to a GFP-positive mESC line. Using the same approach, the gfp gene was also effectively knocked out in hESCs. In addition, a defined single-base edition was effectively introduced into the X-chromosome-linked HPRT1 gene in hiPSCs, generating an in vitro model of Lesch-Nyhan syndrome. T3SS-mediated TALEN protein delivery provides a highly efficient alternative for introducing precise gene editing within pluripotent stem cells for the purpose of disease genotype-phenotype relationship studies and cellular replacement therapies.
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Affiliation(s)
- Jingyue Jia
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Fang Bai
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Yongxin Jin
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Katherine E Santostefano
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Un-Hwan Ha
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Donghai Wu
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Weihui Wu
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Naohiro Terada
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
| | - Shouguang Jin
- State Key Laboratory of Medical and Chemical Biology, College of Life Sciences, Nankai University, Tianjin, People's Republic of China; Department of Molecular Genetics and Microbiology and Department of Pathology, University of Florida, Gainesville, Florida, USA; Department of Biotechnology and Bioinformatics, Korea University, Sejong, Republic of Korea; Key Laboratory of Regenerative Biology, Guangzhou Institute of Biomedicine and Health, Chinese Academy of Sciences, Guangzhou, People's Republic of China
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7
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Hwang WY, Peterson RT, Yeh JRJ. Methods for targeted mutagenesis in zebrafish using TALENs. Methods 2014; 69:76-84. [PMID: 24747922 DOI: 10.1016/j.ymeth.2014.04.009] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/03/2014] [Accepted: 04/09/2014] [Indexed: 12/26/2022] Open
Abstract
The transcription activator-like effector (TALE) nucleases, or TALENs, are customizable restriction enzymes that may be used to induce mutations at nearly any investigator-specified DNA sequence in zebrafish. The DNA-binding specificities of TALENs are determined by a protein array comprised of four types of TALE repeats, where each repeat recognizes a different DNA base. Here, we describe methods for constructing TALEN vectors that have been shown to achieve high success rates and mutation efficiencies in zebrafish. In addition, we discuss simple techniques and protocols that can be used to detect TALEN-induced mutations at almost any genomic locus. These methods should enable zebrafish researchers to quickly generate targeted mutations at their genes-of-interest.
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Affiliation(s)
- Woong Y Hwang
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th street, Room 4201, Charlestown, MA 02129, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA
| | - Randall T Peterson
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th street, Room 4201, Charlestown, MA 02129, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA; Broad Institute, 7 Cambridge Center, Cambridge, MA 02142, USA
| | - Jing-Ruey Joanna Yeh
- Cardiovascular Research Center, Massachusetts General Hospital, 149 13th street, Room 4201, Charlestown, MA 02129, USA; Department of Medicine, Harvard Medical School, 25 Shattuck St, Boston, MA 02115, USA.
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